Correlation between corrected QT interval combined with NLR and MACE events within one year in patients with Chronic Heart Failure

Abstract

Objective: To investigate the predictive value of corrected QT （QTc）interval and neutrophil to lymphocyte ratio (NLR) on major adverse cardiovascular events (MACE) in patients with chronic heart failure (CHF) within one year. Methods: Retrospective in January 2018 to June 2021 in Hebei province people's hospital of cardiovascular internal medicine in hospital patients with CHF, MACE grouped according to whether the patients within 1 year, collect patients clinical data, electrocardiogram (ECG) index, other auxiliary examination and medications, for all the patients by telephone, follow-up outpatient care or electronic medical records, The incidence of MACE within 1 year after discharge was followed up. Multivariate Logistic regression analysis was used to explore the influencing factors of MACE events in patients within 1 year. ROC was used to analyze the predictive value of QTc interval NLR and their combination on the occurrence of MACE in patients with CHF within 1 year. Results: A total of 622 patients were enrolled, including 371 in the MACE group and 251 in the non-MACE group. Compared with the non-MACE group, the MACE group had higher age, proportion of cerebral infarction, QRS duration, QT interval, QTc interval, neutrophil count, NLR, creatinine, treatments with beta-blockers, aldosterone antagonists rate， and lower admission heart rate, ventricular rate, lymphocyte count, and hemoglobin content (P＜0.05).Multivariate Logistic regression analysis showed that age, admission heart rate, QTc interval, NLR and beta-blocker use rate are the influencing factors of MACE events(P＜0.05). ROC analysis estimating the performance in predicting the occurrence of MACE within 1 year in patients with showed that the area under curve（AUC）of QTc interval, score was 0.652（95%CI：0.609-0.695，P＜0.001） with 0.624 sensitivity and 0.61 specificity when the optimal cut-off value was determined as 428.5，the AUC of NLR was 0.649（95%CI：0.605-0.692，P＜0.001）with 0.523 sensitivity and 0.738 specificity when the optimal cut-off value was determined as 4.016， and the AUC of QTc interval and NLR was 0.719（95%CI：0.678-0.760，P＜0.001）with 0.679 sensitivity and 0.695 specificity when the optimal cut-off value was determined as 0.583. Conclusion: Prolongation of QTc interval and elevation of NLR may be independent risk factors for MACE in CHF patients within 1 year, and their combination can be used as predictors of MACE in CHF patients within 1 year.